Abstract
BackgroundA premature myocardial infarction (PMI) is usually associated with a familial component. This study evaluated cardiovascular risk factors in first-degree relatives (FDR) of patients with PMI not presenting the familial hypercholesterolemia phenotype.MethodsA cross-sectional study comprising FDR of non-familial hypercholesterolemia patients who suffered a myocardial infarction <45-years age matched for age and sex with individuals without family history of cardiovascular disease. Subjects were evaluated for presence of the metabolic syndrome and its components, lifestyle, statin therapy, and laboratory parameters.ResultsThe sample was composed of 166 FDR of 103 PMI patients and 111 controls. The prevalence of smoking (29.5 vs. 6.3%; p < 0.001), prediabetes (40.4 vs. 27%; p < 0.001), diabetes (19.9 vs. 1.8%; p < 0.001), metabolic syndrome (64.7 vs. 36%; p < 0.001), and dyslipidemia (84.2 vs. 31.2%; p = 0.001) was greater in FDR. There was no difference on the prevalence of abdominal obesity between groups. In addition, FDR presented higher triglycerides (179.0 ± 71.0 vs. 140.0 ± 74.0 mg/dL; p = 0.002), LDL-cholesterol (122.0 ± 36.0 vs. 113.0 ± 35 mg/dL; p = 0.031), non-HDL-cholesterol (157.0 ± 53.0 vs. 141.0 ± 41.0 mg/dL; p = 0.004), and lower HDL-cholesterol (39.0 ± 10.0 vs. 48.0 ± 14.0 mg/dL; p < 0.001) than controls. Thyrotropin levels (2.4 ± 1.6 vs. 1.9 ± 1.0 mUI/L; p = 0.002) were higher in FDR. The risk factor pattern was like the one of index cases. Only 5.9% (n = 10) of FDR were in use of statins.ConclusionsFDR of non-familial hypercholesterolemia patients with PMI presented an elevated prevalence of metabolic abnormalities, inadequate lifestyle and were undertreated for dyslipidemia.
Highlights
A premature myocardial infarction (PMI) is usually associated with a familial component
first-degree relatives (FDR) of non-familial hypercholesterolemia patients with PMI presented an elevated prevalence of metabolic abnormalities, inadequate lifestyle and were undertreated for dyslipidemia
In this study, FDR of subjects, without clinical suspicion of familial hypercholesterolemia, who suffered an acute myocardial infarction (AMI) before the age of 45 years presented an elevated burden of cardiovascular risk factors mainly type 2 diabetes, Table 3 Comparison of laboratory parameters between firstdegree relatives (FDR) of premature myocardial infarction individuals and controls
Summary
A premature myocardial infarction (PMI) is usually associated with a familial component. This study evaluated cardiovascular risk factors in first-degree relatives (FDR) of patients with PMI not presenting the familial hypercholesterolemia phenotype. Premature coronary artery disease (CAD) is strongly associated with a familial component. Many studies have shown high proportions of cardiovascular risk factors as well as subclinical coronary atherosclerosis in first-degree relatives (FDR) of individuals with a premature myocardial infarction (PMI) [1, 2]. History of CAD is usually defined as a coronary event occurring in a FDR, before ages 55 and 65 years in male and females, respectively [4]. There is little information regarding lifestyle factors that predispose to cardiovascular disease in FDR of AMI survivors younger than 45 years of age
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